Changes from baseline were analyzed using repeated measures mixed–effects analysis of variance; multiple linear regressions of changes in testosterone levels with sexual function, mood, and opioid use were computed.

Results

90/849 patients (10.6%) reported opioid use at baseline; 75/90 (83%) used opioids for ≥30 days prior to baseline.

Baseline total testosterone and prostate–specific antigen were not statistically different between opioid users and nonusers; there was a trend for higher sex hormone–binding globulin (P = 0.08) and lower free testosterone (P = 0.05) in opioid users.

After 1 month, both opioid users and nonusers had significant (P < 0.001) increases in total and free testosterone, which continued through 12 months.

Sexual function and mood improved significantly in both opioid users and nonusers over 12 months, and significantly correlated with change in total testosterone.